Operating room nursing directors' influence on anesthesia group operating room productivity

Area of Science:

• Healthcare Management
• Anesthesiology
• Nursing Administration

Background:

• Anesthesia group productivity is influenced by operating room (OR) nursing administration.
• OR nursing directors' decisions may align with hospital/nurse needs, not anesthesia productivity.
• Reward structures for OR directors were assessed via award nominations and salary surveys.

Purpose of the Study:

• To evaluate the reward structures influencing OR nursing directors' decisions.
• To determine if OR nursing directors are incentivized to improve anesthesia group productivity.
• To understand the alignment between OR nursing director compensation and budget responsibility.

Main Methods:

• Analysis of 164 nomination letters for the "OR Manager of the Year" award (2004-2007).
• Quantified frequency of finance/profit/productivity terms versus relationship-oriented terms in nomination letters.
• Examined salary/career survey data from 303 US OR directors (97% nurses) on budget responsibility and salary.

Main Results:

• Productivity terms appeared in only 2.6% of nomination letter sentences; relationship terms were 9.0 times more prevalent.
• A statistically significant positive correlation (r=0.64, P<0.001) exists between OR director's budget and salary.
• OR directors with larger operational budgets ($36M vs $1M) had salaries 44% higher (22% above/below median).

Conclusions:

• OR nursing directors are incentivized by recognition and compensation to focus on staff relations, not OR efficiency.
• This focus can lead to decisions that do not optimize OR time or reduce labor costs, impacting anesthesia productivity.
• Anesthesia groups should proactively drive productivity improvements, acknowledging nursing directors' institutional constraints.